U.S. Rep. Cathy McMorris Rodgers (R-WA) is calling for the Centers for Medicare and Medicaid Services (CMS) to provide access to Food and Drug Administration (FDA)-approved Alzheimer’s treatments for a broader number of Medicare beneficiaries, including individuals who have Down Syndrome.
Rep. McMorris Rodgers, Republican Leader of the House Energy and Commerce Committee, led a Feb. 8 letter from more than 75 House Republicans to U.S. Health and Human Services Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, expressing concern about a recent proposed National Coverage Determination (NCD) decision memorandum.
The proposal issued on Jan. 11 would set a new precedent for restricting coverage of all FDA-approved drugs using monoclonal antibodies directed against amyloid for Medicare beneficiaries suffering from Alzheimer’s Disease (AD).
“We have significant concerns about what this decision, if finalized, could mean for the more than 6 million American families suffering from AD, including those with other neurological or medical conditions such as Down Syndrome, who may be effectively prohibited from receiving the drug under the proposed process,” the letter said.
Joining McMorris Rodgers in signing the letter were Ways and Means Committee Republican Leader Kevin Brady (R-TX), Energy and Commerce Health Subcommittee Republican Leader Brett Guthrie (R-KY), and Ways and Means Health Subcommittee Republican Leader Vern Buchanan (R-FL), among others.
The lawmakers’ letter explained that the draft decision states that covered patients “must not have: any neurological or other medical condition (other than Alzheimer’s disease) that may significantly contribute to cognitive decline.”
McMorris Rodgers and her colleagues wrote, “This effectively excludes patients with intellectual and developmental disabilities like Down Syndrome. This is a startling exclusion of a significant population that might otherwise benefit from coverage of Aduhelm,” a recently FDA-approved treatment for Alzheimer’s Disease.
The members urged Becerra and Brooks-LaSure to abandon and re-propose the NCD, adding that preventing seniors suffering from a disease from accessing FDA-approved treatments without a reasonable policy “will send mixed signals about the respective agencies’ roles and sow greater confusion.”
The letter also cited several patient advocacy groups opposed to the proposed NCD, including the Alliance of Aging Research, The Alzheimer’s Association, US Against Alzheimer’s, and the National Down Syndrome Society.